Core concepts can be defined as the main components of any theory on which the theory can be formulated or a model can be designed. There are certain concepts which help in the development of nursing theories. There are theories and models developed by different theorists but all of them have same core concepts. The aim of this assignment is to identify a core concept that is common to two or more contemporary nursing theories. Further we have compared and analyzed the concept definitions among the selected theories. After that, we have chosen one theory and discussed where and how it may be best applied to nursing practice. The core concept selected for the purpose of this assignment is obesity while the nursing models selected are Orem's Self-Care Deficit Nursing Theory and Pender's Health Promotion Model.
Obesity in adults is one of the most serious problems of United States. According to a research, nearly 127m Americans are indulged in this disease, i.e. they are overweight. Due to obesity problem, Americans face at least 300,000 deaths each year. (Wilson & Kershaw 2003) Additionally, the cost of healthcare associated with obesity is approximately $100b. (Williams 2001) Most of the nurses who are related to healthcare are facing serious problems due to increased number of patients of adult obesity. In this assignment, we have analyzed the problem of obesity from the perspective of Dorothea Orem and Nola Pender's models.
Adult Obesity's Relevance to Nursing
"The role of obesity in the etiology of diseases such as hypertension, diabetes, and coronary artery disease is well established. Obesity is also recognized as a major risk factor in the development of many other diseases, such as gastro esophageal reflux, arthritis of weight-bearing joints, sleep apnea, and certain types of cancer" (Wang 2001). Obesity is associated with increased morbidity and mortality. Nurses caring for obese patients should recognize the need to use specialized assessment and management strategies to prevent poor patient outcomes.
Approaches to Adult Obesity
The issues related to adult obesity and their application to nursing practice can best be analyzed and described with the help of Pender's Health Promotion Model and Orem's Self-Care Deficit Nursing Theory. The analysis with the involvement of these models can provide a better goal setting for professional nursing practices related to adult obesity.
The premise of Orem's theory lies on the basis of concepts related to goal setting in nursing practice. According to this theory, there is an ability in human beings to take some bold steps in order to regulate their health, life and well-being. (Tomey & Alligood 2002) According to Orem, the Self-care Deficit Nursing Theory (SCDNT) is based on a general theory and is comprised of three theories related to each other. These are; (a) self-care theory in which the researcher has described about the reasons for people to care about themselves, (b) theory of self-care deficit in which it has been argued that there is a specific reason for people being helped through the profession of nursing and (c) nursing system theory which is based on the concept that there is a significant need to build some relationship in order to make nursing practice more efficient and effective. According to Orem, the need for relevant information about the patient is very necessary to determine whether there exists any self-care deficit or not. This information is very important for nurses to create a plan, interventions of nursing and in return producing a very efficient and effective nursing care. Orem did this through a comprehensive assessment test using SCDNT model. (Lannon 2007)
According to Pender's Health Promotion Model, there is an existence of multi-dimensional nature of interaction of persons with the environment in pursuing healthcare. This model is very popular and is divided into several segments which relate to promoting lifestyle. These segments are modifying factors, cognitive-perceptual factors and certain other variables which affect the possibility of any particular action. For maintenance and acquisition of health promoting lifestyle, cognitive-perceptual factors remain the significant participant in the mechanism of motivation for promotional lifestyle. (Hahler 2002) Some of the main components of these factors are perceived health control, health importance, perceived status of health, perceived level of efficacy, health definition and some perceived advantages and disadvantages to the behavior of health promotion. Some of the factors associated with modification of this health promotional model include biological, demographic, interpersonal, behavioral and situational factors. The researcher of this theory, Pender asserts that the focus of health promotion is directed towards a valenced state which is positive in nature and is related to superior well-being and healthcare.
Comparison and Analysis of Concept Definitions among Selected Theories
The theory of Orem helps us to analyze the nursing practice application in a single voice which directs the efficient role of nursing in any healthcare setting related to adult obesity. The collection of important information regarding the patients with the help of vital concepts of Orems' theory will generally help the nursing care unit to define and identify the self-care deficit, if any. The existence of self-care deficit is an alarming situation and is known when a patient does not have an ability to care for himself. Several factors can be identified in the case of obese patient. (Goodwin & Peterson 2002) These factors are universal and can be regarded as requisites which are universal and are related to self-care. These are: food, activity and rest. On the other hand, there are some deviation determinants related to self-care, whose requisites are obesity and ambulating difficulty.
An obese patient should seek advice and knowledge from a certified healthcare professional as the patient would always like to be slim and lose weight. he/she would also like to be seen as more active from his friends and family. Obesity is a very serious issue and it is mandatory for the patient to go for weight loss as the condition of that patient can get worst if particular precautions are not made. This may lead to the development of certain physiological problems. The self-care instinct of obese patient is very necessary and it should come from within the patient. Unwillingness to do so may results in some serious issues. Additionally, the patient also requires a nursing care plan which includes but not limited to pamphlets on healthy dietary foods, an exercise program with increased self-worth, a nutritional consult and positive support from family and friends. Orems' theory can be used as a guide for such patients which provides them with self-esteem, a system of support, know-how about healthy behaviors and this all will result in making ambulation problem much better. (Cox & Taylor 2005)
In Health Promotion Model of Pender, there is a theoretical framework. The purpose of this theoretical framework was to do some investigations related to behaviors of enhancing lifestyle. These include weight loss and exercise. The purpose of this model is to provide guidance to obese persons regarding healthier lifestyles. Some of the important variables in this model for obese persons are ambulating difficulties and exercises.
Implication of Nursing Models
The theories related to nursing are very important in the sense that they are the guidelines for nurses communicating them about the patient care. These theories are the source of information for nurses about fulfilling the individual needs of their patients. The two theories discussed above have several implications for patients have adult obesity.
SCDNT of Orem is a very useful model in applying nursing practices for obesity. It makes it mandatory for nurse to feel the responsibility of patients by providing a consistent framework. This framework encourages nurses to own their patients and lead them to recovery. In order to evaluate and treat obesity, a systematic approach was used by Orem. (Bond & Shannon 2004) Adult obese patient can take advantage from printed materials related to nutrition and weight loss, consult of nutrition, enhanced self-worth and encouragement of support system. All this will help the patient in weight loss. It is the fact that resolution of self-care deficit of patients generally results in prevention from other problems of health. According to Hahler (2002), individuals having obesity problems are at a greater threat for having various health problems. These health problems include cardiac, respiratory dysfunction, hypertension, vascular disease, and some risks related to cancers. So, it is very important that the issue of obesity should be dealt prior to having any additional problems of health.
In order to evaluate any actions or to develop any plans for nursing practice for obese patients, the model of Pender seems to be the best. It focuses on cognitive-perceptual factors and modifying factors which both play a significant role in developing a plan of action for nursing care for obese patients. For obese patients, self-efficacy and inert-personal factors play a very important role in weight loss. It is a fact that overweight patients are prone to have self-confidence that they can lose weight. It's the psychology that creates hindrances in achieving weight loss goals for obese patients.…